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https://www.readbyqxmd.com/read/28299616/promise-of-sglt2-inhibitors-in-heart-failure-diabetes-and-beyond
#1
REVIEW
Pieter Martens, Chantal Mathieu, Frederik H Verbrugge
This review provides mechanistic insight in the pleiotropic effects of sodium-glucose transporter-2 (SGLT-2) inhibitors with particular interest to the pathophysiology of heart failure. The SGLT-2 inhibitor empagliflozin has recently demonstrated an unprecedented 38% reduction in cardiovascular mortality in patients with diabetes. Despite modest effects on long-term glycemic control, highly significant reductions in heart failure admissions and end-stage kidney disease were observed. SGLT-2 inhibitors are the latest approved class of glucose-lowering agents...
March 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28295962/improving-glycemic-control-in-type-2-diabetes-stimulate-insulin-secretion-or-provide-beta-cell-rest
#2
REVIEW
Daniël H van Raalte, C Bruce Verchere
Type 2 diabetes (T2D) is characterized by a gradual decline of pancreatic beta cell function that determines the progressive course of the disease. While beta-cell failure is an important contributor to hyperglycemia, chronic hyperglycemia itself is also detrimental for beta-cell function, likely by inducing prolonged secretory stress on the beta cell as well as through direct glucotoxic mechanisms that have not been fully defined. For years, research has been carried out in search of therapies targeting hyperglycemia that preserve long-term beta-cell function in T2D, a quest that is still ongoing...
March 14, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28295491/national-trends-in-the-treatment-of-diabetic-nephropathy-in-the-united-states
#3
O Ajiboye, J B Segal
WHAT IS KNOWN AND OBJECTIVE: The prevalence of diabetic nephropathy continues to rise and it remains a strong predictor of morbidity and mortality in diabetic patients. Patients diagnosed with diabetic nephropathy are actively excluded from most trials involving diabetic medications and it is important to understand the prescription patterns in this subset of patients with diabetes. METHODS: Using the IMS Health's National Disease and Therapeutic Index, we analysed the medication prescription patterns for six classes of medications from 2010 to 2014 among patients, 35 years or older, with diabetic nephropathy...
March 15, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28276512/the-efficacy-and-safety-of-sglt2-inhibitors-for-adjunctive-treatment-of-type-1-diabetes-a-systematic-review-and-meta-analysis
#4
Jiao Chen, Fang Fan, J Y Wang, Yang Long, C L Gao, R C Stanton, Yong Xu
To assess the efficacy and safety of the SGLT-2 inhibitors as adjunct therapy to insulin in T1DM, clinical trials indexed in PubMed, Cochrane Library, EMbase from inception through April 5, 2016. A meta-analysis was conducted on trials of SGLT-2 inhibitors in patients with T1DM on insulin therapy using RevMan 5.3 software. Of the 371 articles identified, ten met eligibility criteria. Seven clinical trials including four randomized controlled trials and 581 patients were included. Compared with the control group, SGLT-2 inhibitors group had significantly reduced fasting plasma glucose by 0...
March 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28244288/characteristics-and-impact-factors-of-renal-threshold-for-glucose-excretion-in-patients-with-type-2-diabetes-mellitus
#5
Xiao Dan Yue, Jing Yu Wang, Xin Rong Zhang, Ju Hong Yang, Chun Yan Shan, Miao Yan Zheng, Hui Zhu Ren, Yi Zhang, Shao Hua Yang, Zhen Hong Guo, Bai Chang, Bao Cheng Chang
Sodium glucose co-transporter 2 (SGLT-2) inhibitors are newly developed but promising medicine for type 2 diabetes. However, patients with a different renal threshold for glucose excretion (RT(G)) may have a different reaction to this medicine. Therefore, the objective of this study was to investigate the characteristics of RT(G) and its impact factors in patients with type 2 diabetes mellitus (T2DM). The clinical and laboratory data of 36 healthy individuals and 168 in-hospital patients with T2DM were collected and analyzed, RT(G) was calculated using blood glucose (BG) measured by dynamic BG monitoring, urinary glucose excretion (UGE) and estimated glomerular filtration rate (eGFR)...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28222461/elements-for-success-in-managing-type-2-diabetes-with-sglt-2-inhibitors-individualizing-treatment-with-sglt-2-inhibitor-therapy-in-type-2-diabetes-mellitus
#6
Eden M Miller
The largely self-managed nature of type 2 diabetes mellitus (T2DM) underscores the importance of a collaborative decision-making process between patient and provider that best aligns the medication characteristics with the needs, interests, and abilities of the patient and with the treatment goals. The treatment regimen should be kept as simple as possible. This article applies these general principles to the use of sodium glucose cotransporter-2 inhibitor (SGLT-2) therapy, based on evidence from published studies and the clinical experience of the author...
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28222460/elements-for-success-in-managing-type-2-diabetes-with-sglt-2-inhibitors-overview-of-the-efficacy-and-safety-of-sglt-2-inhibitors-in-type-2-diabetes-mellitus
#7
Eden M Miller
Since the approval of the first sodium-glucose cotransporter-2 (SGLT-2) inhibitor by the US Food and Drug Administration (FDA) in 2013, the SGLT-2 inhibitors have assumed key roles in the management of patients with type 2 diabetes mellitus (T2DM). This review covers the safety and efficacy of these agents when used in this patient population.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28222459/elements-for-success-in-managing-type-2-diabetes-with-sglt-2-inhibitors-role-of-the-kidney-in-glucose-homeostasis-implications-for-sglt-2-inhibition-in-the-treatment-of-type-2-diabetes-mellitus
#8
Eden M Miller
The focus on the kidney as a therapeutic target for the treatment of type 2 diabetes mellitus (T2DM) has led to the development of the sodium-glucose cotransporter-2 (SGLT-2) inhibitors, of which 3 are available in the United States. This article addresses the implications for SGLT-2 inhibition in the treatment of T2DM.
February 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/28196866/sglt2-expression-is-increased-in-human-diabetic-nephropathy-sglt2-inhibition-decreases-renal-lipid-accumulation-inflammation-and-the-development-of-nephropathy-in-diabetic-mice
#9
Xiaoxin X Wang, Jonathan Levi, Yuhuan Luo, Komuraiah Myakala, Michal Herman-Edelstein, Liru Qiu, Dong Wang, Yingqiong Peng, Almut Grenz, Scott Lucia, Evgenia Dobrinskikh, Vivette D D'Agati, Hermann Koepsell, Jeffrey B Kopp, Avi Rosenberg, Moshe Levi
There is very limited human renal sodium gradient dependent glucose transporter protein SGLT2 mRNA and protein expression data reported in the literature. Aim 1 of this study was to determine SGLT2 mRNA and protein levels in human and animal models of diabetic nephropathy. We have found that the expression of SGLT2 mRNA and protein is increased in renal biopsies from human subjects with diabetic nephropathy. This is in contrast to db-db mice which had no changes in renal SGLT-2 protein expression. Furthermore, the effect of SGLT2 inhibition on renal lipid content and inflammation is not known...
February 14, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28190822/phloridzin-inhibits-high-k-induced-contraction-via-the-inhibition-of-sodium-glucose-cotransporter-1-in-rat-ileum
#10
Hidenori Kanda, Takeharu Kaneda, Akira Kawaguchi, Noriyasu Sasaki, Tsuyoshi Tajima, Norimoto Urakawa, Kazumasa Shimizu, Hiroetsu Suzuki
Recent studies have shown that phloridzin, an inhibitor of sodium-glucose cotransporter (SGLT), strongly decreases high K(+)-induced contraction in phasic muscle, such as tenia coli, but slightly affects tonic muscle, such as trachea . In this study, we examined the inhibitory mechanism of phloridzin on high K(+)-induced muscle contraction in rat ileum, a phasic muscle. Phloridzin inhibited the high K(+)-induced contraction in the ileum and the aorta, and the relaxing effect of phloridzin at 1 mM in the ileum was approximately five-fold more potent than that in the aorta...
February 11, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28186710/lack-of-health-related-quality-of-life-and-patient-centred-outcome-measures-in-randomized-controlled-trials-conducted-for-diabetes-pharmacotherapy-sglt-2-receptor-inhibitors-as-an-example
#11
Pendar Farahani
BACKGROUND: Use of SGLT-2 receptor inhibitors has been associated with weight loss and a low rate of hypoglycemia in comparison to sulfonylureas. These factors may improve health-related quality of life for patients with diabetes. OBJECTIVES: To systematically explore randomized controlled trials (RCTs) involving SGLT-2 receptor inhibitors that reported health-related quality of life changes. METHODS: A systematic review of SGLT-2 receptor inhibitors clinical trials, limited to RCTs and English language, was conducted utilizing PubMed databases...
January 9, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28169086/basal-insulin-treatment-intensification-in-patients-with-type-2-diabetes-mellitus-a-comprehensive-systematic-review-of-current-options
#12
REVIEW
D Raccah
AIM: As type 2 diabetes mellitus progresses, most patients require treatment with basal insulin in combination with another agent to achieve recommended glycaemic targets. The purpose of this systematic review was to examine the evidence supporting the use of the available add-on treatments [rapid-acting insulin (RAI), glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dipeptidyl peptidase (DPP)-4 inhibitors and sodium-glucose cotransporter-2 (SGLT-2) inhibitors] to basal insulin...
February 3, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28149983/role-of-the-kidney-in-type-2-diabetes-and-mechanism-of-action-of-sodium-glucose-cotransporter-2-inhibitors
#13
Matthew L Mintz
The aim of this supplement is to discuss the important role of the kidney in glucose homeostasis. It produces glucose via gluconeogenesis, it filters glucose from the blood, and reabsorbs the filtered glucose in the proximal tubule, mainly via the sodium-glucose cotransporter-2 (SGLT-2). SGLT-2 is paradoxically upregulated in individuals with type 2 diabetes (T2D), which results in increased glucose reabsorption and hyperglycemia. This core defect in the pathophysiology of T2D provides the rationale for the use of SGLT-2 inhibitors to increase urinary glucose excretion and reduce hyperglycemia in an insulin-independent manner...
December 2016: Journal of Family Practice
https://www.readbyqxmd.com/read/28144158/following-the-results-of-the-empa-reg-outcome-trial-with-empagliflozin-is-it-possible-to-speak-of-a-class-effect
#14
Francisco Javier Ampudia-Blasco, Irene Romera, Bernat Ariño, Ramón Gomis
BACKGROUND: The recently published cardiovascular outcomes data for the first sodium-glucose cotransporter 2 (SGLT2) inhibitor, empagliflozin, have shown cardiovascular safety and additional benefits in patients with type 2 diabetes and established cardiovascular disease. Empagliflozin showed lower rates of death from cardiovascular causes or from any causes and lower hospitalization rates from heart failure compared with placebo, both in addition to standard care. This commentary discusses the existence of a possible class effect considering the available evidence described for other SGLT2 inhibitors...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28120716/sglt-2-inhibitors-and-cardiovascular-risk-in-diabetes-mellitus-a-comprehensive-and-critical-review-of-the-literature
#15
Konstantinos Imprialos, Charles Faselis, Chrysoula Boutari, Konstantinos Stavropoulos, Vasilios Athyros, Asterios Karagiannis, Michael Doumas
BACKGROUND: Diabetes mellitus is a major cardiovascular risk factor. Despite the vast pharmaceutical armamentarium, current therapeutic options for the treatment of type 2 diabetes mellitus were unable to provide consistent cardiovascular benefits, apart for metformin. The newest antidiabetic class of drugs, the SGLT-2 inhibitors, seem to provide significant survival benefits. The aim of this review is to present available data that will clarify whether SGLT-2 inhibitors could precipitate in reducing cardiovascular risk in diabetes mellitus...
January 24, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28120022/-cardiovascular-aspects-of-diabetes-treatment-finally-a-reason-for-cardiologists-to-be-pleased
#16
T Forst, L Plum-Mörschel, M M Weber
Cardiovascular disease significantly determines morbidity and mortality in patients with diabetes mellitus type 2. Large clinical trials in the past left controversial evidence about the effect of blood glucose-lowering treatments on cardiovascular outcomes. In 2008, the regulatory authorities defined new requirements on cardiovascular safety data for the approval of new drugs for the treatment of type 2 diabetes mellitus. Since then, numerous large safety studies have been initiated to prove cardiovascular noninferiority of new antidiabetic drugs...
January 24, 2017: Der Internist
https://www.readbyqxmd.com/read/28116795/novel-oral-glucose-lowering-drugs-compared-to-insulin-are-associated-with-lower-risk-of-all-cause-mortality-cardiovascular-events-and-severe-hypoglycemia-in-type-2-diabetes-patients
#17
Thomas Nyström, Johan Bodegard, David Nathanson, Marcus Thuresson, Anna Norhammar, Jan W Eriksson
AIMS: To investigate the association of novel oral glucose lowering drugs (GLDs) compared with insulin to risk of all-cause mortality, cardiovascular disease (CVD) and severe hypoglycaemia. METHODS: During 2013-2014 all type 2 diabetes patients in Sweden identified as new users of novel oral GLDs, i.e. either dipeptidyl-peptidase-4 inhibitors (DPP-4i) or sodium glucose cotransporter-2 inhibitors (SGLT-2i; only dapagliflozin available in Sweden during the study period), compared to insulin treatment in the Prescribed Drug Register were included and followed in the Patient- and Cause of Death Registers...
January 24, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28116097/functional-imaging-of-pharmacological-action-of-sglt2-inhibitor-ipragliflozin-via-pet-imaging-using-11-c-mdg
#18
Keisuke Mitsuoka, Yuka Hayashizaki, Yoshihiro Murakami, Toshiyuki Takasu, Masanori Yokono, Nobuhiro Umeda, Shoji Takakura, Akihiro Noda, Sosuke Miyoshi
Sodium-dependent glucose cotransporter 2 (SGLT2) is a pharmacological target of type 2 diabetes mellitus. The aim of this study was to noninvasively visualize the pharmacological action of a selective SGLT2 inhibitor ipragliflozin in the kidney using positron emission tomography (PET) imaging with (11)C-methyl-d-glucoside ((11)C-MDG), an SGLT-specific radio-labeled substrate. PET imaging with (11)C-MDG in vehicle-treated rats demonstrated that intravenously injected (11)C-MDG substantially accumulated in the renal cortex, reflecting that the compound was reabsorbed by SGLTs...
August 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28101792/medical-management-of-diabesity-do-we-have-realistic-targets
#19
REVIEW
Joseph M Pappachan, Ananth K Viswanath
PURPOSE OF REVIEW: The global prevalence of "diabesity"-diabetes related to obesity-is increasing steadily over the past few decades because of the obesity epidemic. Although bariatric surgery is an effective treatment option for patients with diabesity, its limited availability, invasiveness, relatively high costs and the potential for surgical and postsurgical complications restrict its widespread use. Therefore, medical management is the only option for a majority of patients with diabesity...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28086872/dapagliflozin-decreases-small-dense-low-density-lipoprotein-cholesterol-and-increases-high-density-lipoprotein-2-cholesterol-in-patients-with-type-2-diabetes-comparison-with-sitagliptin
#20
Toshiyuki Hayashi, Tomoyasu Fukui, Noriko Nakanishi, Saki Yamamoto, Masako Tomoyasu, Anna Osamura, Makoto Ohara, Takeshi Yamamoto, Yasuki Ito, Tsutomu Hirano
BACKGROUND: The sodium-glucose co-transporter-2 (SGLT-2) inhibitors have been reported to increase both low-density lipoprotein (LDL) and high-density lipoprotein (HDL)-cholesterol (C). This study aimed to determine how SGLT-2 inhibitors affect LDL and HDL-C subspecies. METHODS: This single center, open-label, randomized, prospective study included 80 patients with type 2 diabetes taking prescribed oral hypoglycemic agents. Patients were allocated to receive dapagliflozin (n = 40) or sitagliptin (n = 40) as add-on treatment...
January 13, 2017: Cardiovascular Diabetology
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